Normal thrombin generation in neonates in spite of prolonged conventional coagulation tests

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Conventional coagulation tests might be inadequate to explore mechanisms regulating thrombin generation in neonates, because they do not allow full activation of the reduced levels of protein C. Therefore, they do not reflect the action of pro- and anti-coagulants as does the endogenous thrombin potential assessed in the presence of thrombomodulin. Endogenous thrombin potential measured without thrombomodulin was greater than the lower-limit of the adult reference interval in 30% of 109 full-term and 49% of 55 pre-term neonates, a finding consistent with the reduced levels of procoagulants in this setting. When the test was modified adding thrombomodulin, endogenous thrombin potential reverted into the adult reference interval in 97% and 100% full-term and pre-term neonates. In conclusion, the coagulation balance in neonates is restored by the concomitant reduction of pro- and anticoagulants. The restored balance can be shown in vitro by the endogenous thrombin potential test that includes thrombomodulin, but not by conventional coagulation tests.

Original languageEnglish
Pages (from-to)1256-1259
Number of pages4
JournalHaematologica
Volume93
Issue number8
DOIs
Publication statusPublished - Aug 2008

Fingerprint

Thrombomodulin
Thrombin
Coagulants
Protein C
Anticoagulants

Keywords

  • Activated partial thromboplastin
  • Anticoagulant factors
  • Coagulation balance
  • Newborns
  • Procoagulant factors

ASJC Scopus subject areas

  • Hematology

Cite this

@article{5150e9a682e14d6da90d9f47a9317dad,
title = "Normal thrombin generation in neonates in spite of prolonged conventional coagulation tests",
abstract = "Conventional coagulation tests might be inadequate to explore mechanisms regulating thrombin generation in neonates, because they do not allow full activation of the reduced levels of protein C. Therefore, they do not reflect the action of pro- and anti-coagulants as does the endogenous thrombin potential assessed in the presence of thrombomodulin. Endogenous thrombin potential measured without thrombomodulin was greater than the lower-limit of the adult reference interval in 30{\%} of 109 full-term and 49{\%} of 55 pre-term neonates, a finding consistent with the reduced levels of procoagulants in this setting. When the test was modified adding thrombomodulin, endogenous thrombin potential reverted into the adult reference interval in 97{\%} and 100{\%} full-term and pre-term neonates. In conclusion, the coagulation balance in neonates is restored by the concomitant reduction of pro- and anticoagulants. The restored balance can be shown in vitro by the endogenous thrombin potential test that includes thrombomodulin, but not by conventional coagulation tests.",
keywords = "Activated partial thromboplastin, Anticoagulant factors, Coagulation balance, Newborns, Procoagulant factors",
author = "Armando Tripodi and Ramenghi, {Luca A.} and Veena Chantarangkul and {De Carli}, Agnese and Marigrazia Clerici and Michela Groppo and Fabio Mosca and Mannucci, {Pier Mannuccio}",
year = "2008",
month = "8",
doi = "10.3324/haematol.12566",
language = "English",
volume = "93",
pages = "1256--1259",
journal = "Haematologica",
issn = "0390-6078",
publisher = "NLM (Medline)",
number = "8",

}

TY - JOUR

T1 - Normal thrombin generation in neonates in spite of prolonged conventional coagulation tests

AU - Tripodi, Armando

AU - Ramenghi, Luca A.

AU - Chantarangkul, Veena

AU - De Carli, Agnese

AU - Clerici, Marigrazia

AU - Groppo, Michela

AU - Mosca, Fabio

AU - Mannucci, Pier Mannuccio

PY - 2008/8

Y1 - 2008/8

N2 - Conventional coagulation tests might be inadequate to explore mechanisms regulating thrombin generation in neonates, because they do not allow full activation of the reduced levels of protein C. Therefore, they do not reflect the action of pro- and anti-coagulants as does the endogenous thrombin potential assessed in the presence of thrombomodulin. Endogenous thrombin potential measured without thrombomodulin was greater than the lower-limit of the adult reference interval in 30% of 109 full-term and 49% of 55 pre-term neonates, a finding consistent with the reduced levels of procoagulants in this setting. When the test was modified adding thrombomodulin, endogenous thrombin potential reverted into the adult reference interval in 97% and 100% full-term and pre-term neonates. In conclusion, the coagulation balance in neonates is restored by the concomitant reduction of pro- and anticoagulants. The restored balance can be shown in vitro by the endogenous thrombin potential test that includes thrombomodulin, but not by conventional coagulation tests.

AB - Conventional coagulation tests might be inadequate to explore mechanisms regulating thrombin generation in neonates, because they do not allow full activation of the reduced levels of protein C. Therefore, they do not reflect the action of pro- and anti-coagulants as does the endogenous thrombin potential assessed in the presence of thrombomodulin. Endogenous thrombin potential measured without thrombomodulin was greater than the lower-limit of the adult reference interval in 30% of 109 full-term and 49% of 55 pre-term neonates, a finding consistent with the reduced levels of procoagulants in this setting. When the test was modified adding thrombomodulin, endogenous thrombin potential reverted into the adult reference interval in 97% and 100% full-term and pre-term neonates. In conclusion, the coagulation balance in neonates is restored by the concomitant reduction of pro- and anticoagulants. The restored balance can be shown in vitro by the endogenous thrombin potential test that includes thrombomodulin, but not by conventional coagulation tests.

KW - Activated partial thromboplastin

KW - Anticoagulant factors

KW - Coagulation balance

KW - Newborns

KW - Procoagulant factors

UR - http://www.scopus.com/inward/record.url?scp=48749118752&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=48749118752&partnerID=8YFLogxK

U2 - 10.3324/haematol.12566

DO - 10.3324/haematol.12566

M3 - Article

C2 - 18403390

AN - SCOPUS:48749118752

VL - 93

SP - 1256

EP - 1259

JO - Haematologica

JF - Haematologica

SN - 0390-6078

IS - 8

ER -